Opinion: Reduced life expectancy is the real 'American carnage'

By Robert GebelhoffThe Washington Post

Friday

Dec 7, 2018 at 7:58 AM

There's something uncomfortably sterile about life-expectancy rates.

When the Centers for Disease Control and Prevention reports that average American life expectancy shortened by a tenth of a year, as it did last year, it's forgivable if the problem isn't immediately obvious. Sure, we might have shaved off a little more than a month from our lifespans, but at the same time, mortality rates for some of America's leading causes of death, including cancer, heart disease and kidney disease, are falling. What's the difference between 78.7 and 78.6 years?

But behind that loss — behind the clean bar charts and crisp CDC estimates — is the core of our country's most shameful social failures.

The recent downward tick of our lifespans is part of a dismal trend that began in 2015. That places us in the longest period of falling U.S. life expectancy since the 1910s — back when the Great War claimed more than 100,000 lives and hundreds of thousands of others fell to the Spanish flu pandemic.

There are two primary forces behind our recent drop in life expectancy — both the result of systemic crises in the United States. The first, as many others have noted, is drug overdoses. Last year, a little more than 70,000 Americans succumbed to drug addiction, most from opioids such as heroin or painkillers. It's a terrible number no matter how you slice it, though a slight ray of hope broke through the data. Public policy experts believe we might have gotten past the worst of the epidemic (although overdoses due to powerful synthetic opioids such as fentanyl continue to surge).

The second force at play is the United States' gun epidemic. Firearm deaths aren't explicitly included in the CDC's latest numbers, but we can still find them. They are most clearly evident in the report's acknowledgment that rates of suicide, overwhelmingly committed by firearms, increased to new heights last year at 14 deaths per 100,000 people.

And while the CDC has yet to report figures on 2017's firearm-related deaths, data collected by the Gun Violence Archive suggests that the number of non-suicide gun deaths rose by 3 percent. Combined with suicides, that means we're likely to have had around 40,000 deaths from guns last year overall.

But those numbers mask even more disturbing disparities. A new study published this week in BMJ, formerly called the British Medical Journal, estimates that gun violence has shortened the life expectancy for black Americans by almost twice as much as it has for white ones. Combining data from 2000 to 2016, the study found that guns shaved a little more than two years off white Americans' lives; black people, however, had to forfeit more than four. Most of that difference resulted from violence that claimed young black lives during adolescence and young adulthood.

Where is our shame? We are, by leaps and bounds, the wealthiest nation in the world. We boast medical achievements no other country can claim. And slowly but surely, we are reducing deaths from our most persistent public-health problems. Yet we allow ourselves to be dragged down by such social and racial disparities?

Republicans, to their limited credit, have passed legislation in an attempt to the curb the opioid epidemic, but the paltry funding they dedicated to it illustrates their true commitment to the issue. Meanwhile, Republicans at the state level are scrambling to add bureaucratic hurdles to health care coverage for low-income Americans. And we're all well aware of our government's complete failure to address gun violence — even though plenty of sensible reforms could reduce deaths, including suicides.

President Donald Trump set out on his Inauguration Day to end "American carnage." But it's continuing, and the evidence is plain for all to see.

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